A new study from Uppsala University shows that oral contraceptives and hormone replacement therapy during menstruation increase the risk of stroke. The risk of recurrence is higher in the first year of treatment and then decreases. The study, which is now published in pulseis based on data from over a quarter of a million women from UK Biobank.
“The women who started taking it oral contraceptives it is twice the risk of experiencing stroke, but only in the first year of use. If they continue to take birth control pills, the risk is reduced and after more than a year of using them, we see no further risk, ”said Therese Johansson at the Department of Immunology, Genetics and Pathology at Jami Uppsala, and one of the leading researchers.
Globally, stroke is the second most common cause of disability death early, which equates to 11% of the annual death toll. It is caused by a change in blood pressure blood flow to the brain, either because of the blockage caused by blood –brain pain– or to cerebral palsy.
The so-called estrogen receptor antagonists can be taken as oral contraceptives to protect against unwanted pregnancy, or as a hormone replacement therapy during menstruation to compensate for the loss of isrogen that occurs during pregnancy. Hormone treatment helps to reduce the symptoms of menopause, including hot flashes, dryness of the vagina and climate change.
Estrogen has been shown to have a protective effect on blood vessel health, but it is also associated with an increased risk of blood clotting.
In a randomized study, based on data from the UK Biomedical Database UK Biobank, the researchers compared the incidence of stroke and specific types of stroke, stroke and stroke. of the brain, between mata which carries exogenous hormones and those that do not.
“In the years when women start taking birth control pills, very few suffer from stroke. risk of life between those who have taken oral contraceptives and those who have not, so it is rare, even if there is an increased short-term risk, ”said Therese Johansson.
Hormone therapy has previously been linked to an increased risk of stroke when taken several years after menopause. It is also recommended that it protects against stroke if it is started before menstruation or after menstruation.
“We saw an increased risk of both types of stroke, stroke and cerebral palsy, in the first year of hormone therapy, and the risk of cerebral palsy was higher after the first year. Stroke in women who start hormone therapy even before menstruation hormone therapy It also increases the risk of stroke when menstruation begins, while those who have been treated have no increased risk of stroke when they start menstruating, ”said Asa Johansson, one of the study’s authors.
“It is important to emphasize that most women tolerate hormones well and can benefit from their effects. unprepared stomachs and they can prevent many diseases affecting women, including ovarian cancer and endometrial cancer. Hormone therapy can greatly improve quality of life by reducing it signs of menopause and can prevent osteoporosis. However, some women increase their risk of stroke with the use of external hormones and our research may help women and doctors make better decisions about what women should use hormones for, ”said Therese Johansson.
Therese Johansson et al, Oral Medicine, Hormone Replacement Therapy, and the Risk of Stroke, pulse (2022). DOI: 10.1161 / STROKEAHA.121.038659
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